Qu Jinrong, Han Shuai, Zhang Hongkai, Liu Hui, Wang Zhaoqi, Kamel Ihab R, Berthold Kiefer, Dominik Nickel Marcel, Zhang Jianwei, Zhang Shouning, Dong Yafeng, Jiang Lina, Liu Cuicui, Li Hailiang
Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China, 450008.
Transl Oncol. 2017 Feb;10(1):46-53. doi: 10.1016/j.tranon.2016.11.005. Epub 2016 Dec 7.
To evaluate lesion enhancement performance of Multi-Arterial CAIPIRINHA-Dixon-TWIST-Volume-Interpolated Breath-Hold Examination (MA-CDT-VIBE) for the detection of hepatic metastases.
Thirty-one patients with suspicious hepatic metastases were enrolled in this retrospective study. Two independent radiologists scored visualization of each lesion on a scale of 1 (poor visualization) to 11 (excellent visualization) on 11 sets of images. These included 6 hepatic arterial sub-phases acquired in one breath-hold, 1 series of the mean of 6 hepatic arterial sub-phases, 3 subtracted arterial sub-phases, and 1 portal venous phase. The phases with good (score 8-10) and excellent (score 11) lesion visualization were identified, and the number of lesions seen on each of these phases was compared to the number of lesions that was seen best on the equivalent-to-conventional single arterial phase as well as to those that were see best on the mean of 6 hepatic arterial sub-phases. Inter-reader agreement was also calculated.
The MA-CDT-VIBE was successfully acquired in 25 patients with hypervascular metastases (96 lesions) and 6 patients with hypovascular metastases (13 lesions). In case of hypervascular metastases, the 6th/6 arterial sub-phase had excellent lesion visualization (sore of 11) in 56 and 44 lesions for the 2 readers, respectively. Good lesion visualization (score of 8-10) was recorded in 5th/6 arterial subphases, in 81 and 67 lesions for the 2 readers, respectively. In case of hypovascular metastases, the portal venous phase had excellent lesion visualization (sore of 11) in all 13 lesions for the 2 readers. Good lesion visualization (score of 8-10) was recorded in 12 and 13 lesions on the 5th/6 and 6th/6 arterial subphases, respectively. More hypervascular lesions scored good (score of 8-10) and excellent (score of 11) on the 5th/6 and 6th/6 phases of MA-CDT-VIBE compared with the equivalent-to-conventional single arterial phase (3rd/6) and the set with mean of 6 hepatic arterial sub-phases. The results were statistically significant (t test, P<.0001). Inter-reader agreement was good for hypervascular lesions (kappa=0.627, P<.0001) and excellent for hypovascular lesions (kappa=1.0, P<.0001), respectively.
The MA-CDT-VIBE improves lesion conspicuity by providing a wide observation window for hypervascular lesions. For hypovascular lesions, the advantage of multiple arterial sub-phases over the portal venous phase is not apparent.
评估多动脉CAIPIRINHA-Dixon-TWIST容积内插屏气检查（MA-CDT-VIBE）对肝转移瘤的病灶强化表现，以用于肝转移瘤的检测。
本回顾性研究纳入了31例怀疑有肝转移瘤的患者。两名独立的放射科医生在11组图像上，按照1（显示不佳）至11（显示极佳）的评分标准，对每个病灶的可视化程度进行评分。这些图像包括一次屏气采集的6个肝动脉亚期、6个肝动脉亚期平均值的1个序列、3个减影动脉亚期以及1个门静脉期。确定病灶可视化良好（评分8 - 10）和极佳（评分11）的阶段，并将这些阶段中看到的病灶数量与在等效于传统单动脉期以及6个肝动脉亚期平均值上显示最佳的病灶数量进行比较。还计算了阅片者之间的一致性。
25例有富血供转移瘤（96个病灶）和6例有乏血供转移瘤（13个病灶）的患者成功完成了MA-CDT-VIBE检查。对于富血供转移瘤，在第6/6动脉亚期，两名阅片者分别在56个和44个病灶中观察到病灶可视化极佳（评分11）。在第5/6动脉亚期，两名阅片者分别在81个和67个病灶中观察到病灶可视化良好（评分8 - 10）。对于乏血供转移瘤，在门静脉期，两名阅片者在所有13个病灶中均观察到病灶可视化极佳（评分11）。在第5/6和第6/6动脉亚期，分别在12个和13个病灶中观察到病灶可视化良好（评分8 - 10）。与等效于传统单动脉期（第3/6期）和6个肝动脉亚期平均值的图像集相比，更多的富血供病灶在MA-CDT-VIBE的第5/6期和第6/6期显示良好（评分8 - 10）和极佳（评分11）。结果具有统计学意义（t检验，P <.0001）。阅片者之间对于富血供病灶的一致性良好（kappa = 0.627，P <.0001），对于乏血供病灶的一致性极佳（kappa = 1.0，P <.0001）。
MA-CDT-VIBE通过为富血供病灶提供宽观察窗提高了病灶的辨识度。对于乏血供病灶，多个动脉亚期相对于门静脉期的优势并不明显。
